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Does Empowerment Predict Vaccine Uptake? Identifying Early Adopters of Recently-Introduced Childhood Vaccines in Malawi

Abstract

The Human papillomavirus (HPV) vaccine was introduced to Malawi to reduce the high rate of cervical cancer mortality among Malawian women. This thesis analyzed 2015-16 Malawi Demographic and Health Survey data collected from currently married or partnered women ages 15-49 to identify characteristics associated with adoption of two recently-introduced childhood vaccines (rotavirus and pneumococcal), which served as a proxy for the HPV vaccine. Multivariate logistic regression was conducted to identify early adopters who had vaccinated their youngest child against rotavirus and pneumococcal infection. The results of my analyses show that women’s empowerment, assessed through participation in family decisions and attitudes towards violence, women’s exposure to media, and women’s employment status were positively associated with adoption of both the rotavirus and pneumococcal vaccines. Identifying which Malawian women are less likely to vaccinate their children could inform specialized interventions designed to reach these sub-populations. Identifying determinants of vaccine adoption is an important step towards improving HPV vaccine uptake and ultimately reducing cervical cancer mortality in Malawi.

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